| NPI | 1922474816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 57127) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03442786) |
| 183500000X Pharmacist (Licence: KY 024525) | |
| 183500000X Pharmacist (Licence: MO 2025012611) | |
| 183500000X Pharmacist (Licence: IN 26031369A) | |
| 183500000X Pharmacist (Licence: IL 051306197) | |
| 183500000X Pharmacist (Licence: PA RP457568) | |
| 183500000X Pharmacist (Licence: FL PS67017) | |
| 183500000X Pharmacist (Licence: HI PH-4912) | |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2025-07-31 |